Sir Stephen Bubb

Sir Stephen Bubb

Thursday, 28 April 2011

Spinning DWP and the wedding

What is going on in DWP ? Yet another selective release of data on welfare claimants. This time its not the fat and drug addicted singled out but those claiming sickness benefits.

We are told that significant numbers of claims have been turned down and indeed many people have withdrawn from the process. So the image of thousands of wicked and indolent people trying to buck the system is built up. 

The fact that some of those that have withdrawn from claims may have been put off by the convoluted and increasingly intimidating process is left unexplained. For example, we know that people with mental health problems are a group that has particular difficulty in claiming benefits. But never mind that. 

Coupled with the highly distasteful publication of data on obesity and drug-drink addiction, closely followed by speeches on same subject by Chris Grayling MP and the PM ( no coincidence there surely? )this is looking like a pattern. 

We have been here before. Blame the unemployed for their own misfortunes. They are scroungers. Or fraudsters. Or morally corrupt people on drugs and drink. Or worst.

Never mind the laws of economics which show that in a recession there are less jobs. Let's argue that all those fat drunk people need to do is get off the sofa and get themselves into Job Centre Plus where hundreds of tempting jobs are on offer with their name on them. Of course employers are only too delighted to take on all comers, whatever their work history.

 Now I'm not niave; I realise there are elections ahead and it is always tempting to pander to base predujdice in such circumstances , but perhaps I'm old fashioned and think our elected representatives have a leadership duty.

Anyway I'm glad to say the building enthusiasm for The Wedding has knocked this bit of news of the airwaves.  I went up to join the crowds outside the Abbey and then at the Palace. And even bought a William and Kate commemorative Union Jack! Now adorning the front door. And I can take it off tomorrow to the Street party I'm going to at my brothers in Richmond.

 
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Wednesday, 27 April 2011

O joyful Eastertide

A day of contrasts. I started off with a meeting at Monitor, nicely situated behind Central Hall so I had a pop around the Abbey to see the preparations for The Wedding ( this was before the trees arrived ) !

Monitor will play a crucial role in regulating competition under the Bill so obviously a focus for attention. I'm not at all sure that calling it an " economic regulator" is a useful phrase. Our NHS is surely much more than economics? 

The relations between the new NHS Commissioning Board , Monitor and the GP consortia will be crucial. So how this is to work is a key focus for my enquiries. How does Monitor " promote competition" ? How does it intervene if it thinks that GP consortia are acting against the wider interest of patients and limiting choice by providing much more themselves and excluding other providers? 

The infamous Public Accounts Committee, under my old friend from London council days, Margaret Hodge MP has just published a report questioning how the new system will work in terms of efficiency and accountability. She raises good questions we should look at. I shall be in touch with her.

I rather took to David Bennett who runs Monitor. I have to say my initial impression , from when I appeared with him on the Bill Committee hearings at the Commons was not as favourable. A typical grey suit I thought. But he isn't. And indeed had a rather splendid tie in the Bubb mold. I left them with some thoughts. And we shall meet again.

Then it was off for an enjoyable lunch with my old friend Oliver Rothschild and a colleague of his, John Kearon, The chief juicer of Brain Juicer!

Brain juicer is a remarkable marketing company with a particular take on how marketing should be done- based on recognising and appealing to our emotions and not to our logic. We had a fascinating discussion about how this is relevant to charity campaigns and marketing. I'm going to get him to speak to The Impact Coalition.

Lunch over it was off to an hour's torture with my personal trainer and I recovered with planting geraniums.

And in case you think this is a rather light day of leisure I should add that this week the Acevo office is closed. We decided that because we could not afford to give our staff a pay rise this year and because they have been working so brilliantly and so hard we would give them the 3 days this week as leave so everyone can get a real rest and recovery and come back ready for new battles.

But the Boss of course gets no such break as he battles with health reforms.


 
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Thursday, 21 April 2011

NHS Future Forum meets!

The Mint Hotel made an unlikely venue for the first meeting of the new NHS Future Forum, set up to listen to concerns about and to review the Health Bill to see if changes can be recommended.

Some 40 of us: doctors and clinicians, third sector leaders , local government, nurse leaders and health service managers; debating the reforms. Opinions varied on where we have got to and where we are going . Arguments and discussion. How can we make GPs accountable? Is this pause just interfering with the health service getting on with their job? Are we being privatised? Do professionals have too much power? Or too little? Is choice good for you? One thing is for sure; this is not a bunch of Government lickspittles! Indeed one member made clear he was not there to " dig the Government out of its hole".

I guess the only issue is whether I shall be able to draw my lovely band of experts looking at choice and competition into a coherent whole that will recommend the changes we want to see there ? I have a group of 10. Feisty and self opinionated ( I believe this is a compliment! ) and not afraid to speak their kinds - sometimes all at once! So on my group I have the shy and retiring Victor Adebowale, CEO of the fantastic and innovative charity Turning Point, Tom Hughes-Hallet from one of the country's most loved charities Marie Curie, a couple of enthusiastic reforming GPs, a President of a Royal College who gives us class and distinction, a council CEO and top rank health service managers.

There were some superb interchanges. A fun debate on how accountable GPs will be. Do the public view them as distant and disconnected? That sparked a debate I can tell you!

We agreed we will have a couple of further meetings and a weekly phone conference call as well as email exchanges , listening events and research gathering. One thing is for clear. This is a rough and ready exercise and we have effectively only 4 weeks for this work. But this is not another consultation and I'm convinced we will be able to come up with something of value and use and advances the public good.

I'm now off to a roundtable with ACEVO members to discuss the reforms. We are having 2 such events. I am also in touch with my colleagues in ncvo, social enterprise and navca about getting their member's views. We are also to hold a third sector day to gather views and opinions.

But today is Maundy Thursday. The solemn celebration of the events of the Passion begin in earnest. I shall be at All Saints tonight for the reembrance of the Last supper and the washing of the feet of 12 local citizens. I liked the thought for today on BBC this morning from my Charlbury neighbour The Arch bishop , who suggested a new law for members of the cabinet, top financiers etc to be obliged to undertake a number of hours of community service with the poor. A good idea.

Actually seeing the PM on an estate in Brixton washing the feet of 12 homeless people would be a great example to set. And somewhat better than the distasteful release of figures from DWP today castigating the obese and drink addicted. There is emerging a nasty tendency to try to blame the unemployed for their misfortunes and return to a concept of the deserving and undeserving poor. This concept is at variance with Christian teaching and the release of these figures on Maundy Thursday by the DWP is to be deplored and condemned .

Citizens 4 : Birmingham Council 0. Celebrate!

Fantastic news as I get home and flop on the sofa. The High Court have found against Birmingham City Council in a case brought by 4 severely disabled people who fought the disgraceful decision by the Council to limit or remove their care.

Can you imagine what the Council were planning to do ? A 25 year old man with a rare genetic disorder and learning difficulties who needs 24 hour care in a home paid for by the Council was to lose this. The High Court have said the decision was unlawful.

This is a brilliant decision. Too many councils have made bad decisions like this. There will be other legal challenges. I hope all third sector bodies challenge bad decisions and use the courts to protect vulnerable citizens. Judicial Review should be a crucial tool in our box of tricks when fighting for our beneficiaries. Equalities and disability law should be enforced. And it is our job to see they are. I hope all councils take note!

But we ought to be moving to a better relationship between councils and the third sector. What councils need to do before they go for bad decisions , is to talk to the sector and look at alternative ways to provide services through the sector. That might be through local or national charities and social enterprises.

That is why the proposed statutory guidance by Eric Pickles is so important. Telling councils to have a 3 month pause before implementing decisions like this whilst discussions take place.

ACEVO is planning a top level strategic awayday for our CEOs from the third sector and from councils. Let's get the relationship better!

In the meantime let's celebrate the power of citizens and the victory over arbitrary council power.

Wednesday, 20 April 2011

83 and onwards

It's my Father's birthday today. 83 is not a bad age and , as I'm now an expert on health matters I was able to tell him he has significantly less long term conditions than many his age. He was off to the village pub for a pint ( I recommended 2 ), ploughmans and afternoon snooze ( in that order).I can report for all those dog loving blogg readers out there that the Hound successfully swallowed worm tablet. And loo is safely installed. I'm sure you are relieved!

So it was off to a meeting with GPs at the Department. I suggested that there are 3 main drivers of change behind the health reforms:

# an ageing population ( a quarter of today's children will reach 100 )

# burgeoning long term conditions

# patient and citizen power

That means that whoever was I power , reform of the NHS was going to happen.

It's interesting that many of my baby boomer generation are now coming face to face with the issues around care for the elderly in our current system. We like and appreciate the fact that our NHS is free a to use and that even hugely expensive treatments are available to all, regardless of income. Let's keep it that way!

But let's also be honest that care for the frail elderly ( not you dad !) can often be shockingly inadequate. And the current medical model for long term conditions is unsustainable. Given  growing patient power this makes for a heady mix for health spending!

I had a superb meeting with 2 outstanding examples of forward looking and brave thinking GPs from the NHS Alliance, Dr Dixon ( who Chairs the Alliance) and Dr Hynes.

 We have made a good connection between ACEVO and the Alliance and intend to do some joint work, together with Ippr,on how to promote the third sector to GPs. We were planning all this long before the "pause" but it proved doubly useful to get their views on the reforms.

I have to admit that when I hear from GPs like the two I met yesterday , I see the huge potential of GP commissioning for more effective public health.

Dr Dixon made the interesting point that the Lansley model returns GPs to their historic role in the country,  where the GP was a pillar of the local community and saw the connections between public and individual health, jobs and a good environment.

Dr Hynes put it rather brilliantly in describing how we treat depression: no good just dispensing tablets when the fact is that the people he sees have mega reasons to be depressed; no job, benefits cut, housing problems etc. So acting on those problems is as crucial to better health as a pill. They both gave me interesting examples of how they make use of the local third sector to support the people they see.

But is this the general picture for all GPs?  A thought occurs to me. Should we be insisting that the new GP commissioning consortia are set up a CICs ( community interest companies ) ? Should we encourage GP practices to set themselves up as CICs? There is , after all, concern that the new arrangements do not give rise to excessive private, as opposed to public profit.

I leave the good doctors for various meetings at No 10. The first , an interesting collection of key media and comms leaders from the third sector meeting with Steve Hilton and the feisty Caroline Deihl ( ACEVO member, CEO of the Media Trust ) to talk about whether the sector could play a bigger role in encouraging social action through public awareness campaigns . Can Government help promote or support this , especially with encouraging media support ?

We met in the Cabinet Room; if only I had a camera to record the historic sight of third sector leaders sitting around the Cabinet Table. I was sat next to that force of nature, Emma- Jane Cross of Beat Bullying. Fizzing with ideas ( was there something in the coffee? )she played a great role in pushing the debate forward. We are to meet again. 

She also has a famous Blog. I tell her I shall mention her. There you go.

Then its off upstairs for another in the listening roundtables that the PM and Andrew Lansley  are  holding. A meeting with the Foundation Trust Network. A good meeting that took place under the glaring presence of Margaret Thatcher ; portrait on wall, it was previously her office I'm told  .  Reassuring to discover that it is not just meetings of third sector folk that spend time whinging about not having enough money.not that I'm complaining about that; I whinge for the nation about cuts to our sector. And , after all , we now have news of increasing waiting lists in hospitals so the fact that cut backs are happening does flow through to the front line of patient care.

The evening was rounded off over a glass of Chablis! I was meeting with Chris Sterling and Mary Reilly from Deloitte. Deloitte have been a long standing corporate partner of acevo and Chris and Mary had agreed to meet up to brainstorm some of their experience and knowledge  of the health sector and its challenges. We begin at the beginning. How do you define choice! What does it mean in practise.

He shows me some interesting research that demonstrates that the exercise of choice works better in city centres, but not in rural ones. So inequality can build up; a point I need to reflect on.

I get home late realising I have had neither lunch nor dinner. Is this healthy? I must ask my Doctor!

Tuesday, 19 April 2011

Listening and worm tablets

A mundane start to Monday. I had to get a worm tablet for She who Must Be Obeyed ( my Hound ), a new toilet and a haircut. Somewhat of a come down from yesterday's spiritual events.

And I even make an appointment with my GP ( NOT part of the listening exercise). Can someone tell me why I have to take time off work to see my doctor? Most parts of the public sector can manage to open evenings or Saturdays. Why can't Doctors? Must ask Steve Field tomorrow!

These tasks accomplished it was into the DH for more meetings with officials as I attempt to get my head round this challenge I have on choice and competition! I'm reminded about how political this is by a rather pointed email from an ACEVO member which says, " the White Paper is fundamentally about privatisation. "

Actually I think as a matter of fact it is not , though there are certainly arguments put that says the direction of travel points there? Choices do have consequences. Yet how do you achieve choice without more diversity in providers. And as I have argued with relentless monotony for the last decade we have to expand the role of our third sector if we are to meet the challenges of NHS provision for the future.

What does the third sector bring to health?

# advocacy and the championing of citizens and patients rights,

# research ( some charities do more research in some health areas than the NHS )

# service delivery that is often more patient centred and cost effective. We need more of this, not less

# More opportunities for staff to set up social enterprises. Use the right to request

# More opportunities to deliver services for long term conditions and end of life care

Of course there is then the issue of the role of the independent sector and that's the point of contention.

I'm getting a lot of emails suggesting meetings, ideas , as well as hints on what I shouldn't do ! As I see the process, its about meetings and discussion, as well as talking to experts. I'm trying to do a lot of this.

But lets be clear. This is not a new consultation; that has happened . There is a Bill in Parliament. And this is a time limited exercise; indeed we have only about 6 weeks in reality.

And I don't have a magic wand that produces an answer to a hotly debated and contentious political issue.

The process is fascinating and I am meeting new people, trying to think out of the box whilst knowing I'm surrounded by professionals who have been in the health service for years. I'm just the naïve new boy..well not so naïve!

But what is also true is that you need to avoid closed group thinking. Professional groups across the sectors can sometimes think in ways that exclude ; the experience of people , carers and families involved in mental health and learning disabilities can bear witness to that.


An interesting editorial in Third Sector by the Editor, stephen Cook, points to my dilemma.

" Last week, seven voluntary sector leaders announced they were to join the exercise, which has been christened the NHS Future Forum. Sir Stephen Bubb has even agreed to take two months away from his job running the chief executives body Acevo to "take the lead" in the strand of the forum's work that relates to choice and competition.


It will be argued that it is better for the sector to be inside rather than outside the tent when such a vital policy area is under review, and that there is a rare opportunity here for health charities to exert significant influence on ministers and policymakers. It is indeed their chance to press for their specialist, patient-centred services to gain better access to the NHS on a more level playing field.

But there are reputational risks here as well. The government's overriding imperative is to get its flagship reforms back on track, and there is a danger that it will try to use the sector as window-dressing in this essentially political enterprise. The sector leaders involved would do well to guard their independence and sup with a long spoon at this particular gathering.

In this connection, Bubb confides on his blog that he was persuaded by the Department of Health press office not to take up a BBC interview slot about his appointment. This is hardly a good omen, and he would do well to fulfil quickly his accompanying pledge that this unusual silence on his part won't last. In an arrangement like this, it needs to be absolutely clear who's calling the shots."

Well, that's marking my cards then!


But I ended the evening with a gorgeous tea and scone with an old friend as we chewed the cud and ruminate on what I'm trying to do. In tasks like this you need friends to keep you on the right track!

Monday, 18 April 2011

Palm Sunday and Health

My sister Lucy, who was once an NHS manager before she escaped to Deloitte sends me an interesting article which maybe heralds a good way forward for GP commissioning; a GP practice has appointed patients to head up its board .

The Arlesley Medical Centre in Bedfordshire has elected patients as chair and vice chair of the practice as part of its transformation into a not-for-profit social enterprise, which it says will enable it to provide a more tailored service to its local population.

The move has seen the practice evolve into a 'John Lewis' style partnership, with all practice staff handed a stake in the business.

Arlesley is understood to be one of the first individual practices in the country to become a social enterprise, although some larger social enterprises, such as the Harness GP cooperative in Brent, currently run GP practices.

Dr Mike Attias, lead GP at centre, a remote rural practice formerly run by the PCT, said he thought the model, could be a blueprint for other rural practices in the future .

He said: 'Our company chair and vice chairs are patients, which is real people power. Traditionally one would have defaulted to a partnership model. But we wanted to put patients at the very centre.'

He added: 'We will be offering a more varied service. This could be reproducible in small rural communities.'

Dr Attias said the practice hoped to increase its list size from 2,700 to 3,200 by offering a more bespoke service to patients, with extended opening hours and patient involvement that moved beyond 'tokenistic' patient participation groups.

He said: 'We’ve modelled ourselves partly on the John Lewis model in that all employees become members of the company. Everybody has a £1 share of the company.'

And this is not the only example. At the No 10 roundtable last week we heard from another medical practise in Salford which was one of the early " spin outs" and is a thriving social enterprise.


Yesterday was a glorious spring Palm Sunday. I joined the congregation at All Saints Margaret St for the Palm Procession by Oxford st. It gave the tourists something else to gawp at! The Mass was the setting by Rachmaninov, in B , which the organist at All Saints adapted from Rachmaninov's Mass for St John Christyhom. Rachmaninov came to all Saints to hear it sung for the first time and pronounced himself " satisfied".




Then in the evening it was off to St Paul's , Knightsbridge for a BBC Radio 3 broadcast of sacred music for Palm sunday. It was being broadcast around Europe so my cough must have been heard by millions!

And finally, as we gear up for The Wedding here are a couple of shop window displays I liked. One in near my local cafe in Herne Hill, the other in Knightsbridge. Guess which is which!




Friday, 15 April 2011

Choice; yes please!

In at the deep end this morning with a session on procurement and commissioning in health with the Department's top expert Bob Ricketts. I've known Bob for some time and like him a lot. He has a very clear understanding of the role that diversity of providers brings to the choice agenda and how valuable a role our sector can play. We had a good canter around the tricky issues behind the current political debate and I emerged with some ideas I can try out and discuss in the listening exercise.

He was pleased with my interview in the FT that morning; as indeed was I. The article was accompanied by 3 talking head quotes; me, Ed M and Andrew L!

I needed to clear my head so walked to my next meeting; lunch at Mon Plaisir with the marvellous Nick Seddon from Reform, the think tank that has had some interesting , if sometimes controversial, ideas on health reform. He has promised me lots of evidence and research on how competition extends choice and provides better value for the NHS, including evidence from Europe. And we chat on where Big Society has got to!

Back to my office at ACEVO to meet further people to continue the evidence gathering and to remind my ACEVO team I'm still alive! They have not yet changed the locks...

I'm chuffed at a letter I have received from the Chancellor, cousin George. It's about the Community Investment tax relief scheme. It was recommended for abolition but , in the end George Osborne decided to retain the scheme. The only one of the many reliefs that were recommended for abolition that he saved. He had added a postscript to the oficial letter; he wrote " your letter helped persuade me ". How cool is that: ACEVO saves the CITR ! Official !

Dinner with Stephen Thornton who runs the Health Foundation and is a leading expert on the health service- back in time for a particularly poor debate on Question Time on the health reforms! They should have had me on there to correct Peter Hain MP for his nonsense on EU competition law! This will need a better explanation !

Some thoughts so far;

# Choice in our NHS is not simply about what hospital to go to but more importantly , how to get involved in all clinical decisions about our own treatment and care.

# Lansley's marvellous declaration ," no decision about me without me" needs reinforcing.

# How might we extend the success of personal budgets in social care to health care? With long term conditions being handled so imperfectly in the current arrangements ; giving citizens more control of how budgets are spent on their own care has to be both right in principle and a better use of money. It's a disgrace how much money is wasted in the NHS on expensive retinal eye tests carried out in doctor surgeries when you can get it so easily and more cheaply ( and at weekends and evenings! ) down at a High St optician! Let's hope GP commissioning will sort that out!

# How can we sort out lack of choice in making choices on end of life care? How shocking that many people who want care to be provided at home or in a hospice end up dying in an expensive hospital bed ( average cost £2000 per day ! ).

# Many people have bad experiences of the care our current system gives to older people. How many people do you know who have horrible stories of the way their elderly parents are treated? One thing is for sure , the baby boomers - that's stroppy people like me - won't put up with the type of treatment often meeted out in some parts of our current system for vulnerable old people . And as we live longer the NHS will need to get this sorted.

# Are professional interests too powerful? We need the strength and skill of our health service professionals. But we also need empowered patients and citizens with voice and choice . How can the current reforms strengthen our power to make decisions about our own health ?

# There is so much evidence from mental health and disability charities that shows giving more power to the patient or client improves their health and well being. So more partnership in developing care plans, is crucial . Again I hope that GP commissioning will start to look for innovative new ways to empower citizens and new partnership working that promote professionals working with patients to ensure we are in charge of our own health and well being .

And now I'm off to Guys hospital for my annual scan. I think I shall mention my role on the Future Forum after the scan rather than before; we don't want anything going wrong do we!

Thursday, 14 April 2011

New boy at work!

Well I now have a share of a desk ( 6th floor,attic, at back) and a pass for DH. After the No 10 breakfast roundtable I spent the day in the Department trying to get to grips with the new role I've taken on. It was a bit like new boy at school as I wandered around , getting lost and meeting lots of interesting people whose names I only vaguely remember ! A great first session with Sir David Nicholson, the NHS ceo. A meeting of minds on some of the challenges we face on the commissioning front.

I have been assigned a minder; a clearly top class civil servant who is heading for Permanent Secretary at some stage ( unless we head hunt her for the third sector , of course).

And a first! The DH press team persuaded me not to take up a BBC interview slot. My staff back at ACEVO towers nearly expired with the shock. Mind you, it won't last!

But I feel I'm beginning to get my head round some of the key issues. I suspect it is important for me to focus on big picture, on what we can change for the better and not get deluged under the detail of a 600 page Bill.

The third sector roundtable at No 10 was both hugely encouraging and inspiring. We had Lansley, Clegg and the PM. I must say that whilst many people have been saying that Andrew Lansley has not communicated well , he was very clear and articulate on the purpose of the reforms, the fact that it is about putting choice at the heart of reforms and that competition is a means to an end. This is something I feel strongly is right.


One point that emerged strongly from a question from the PM is that many members feel that GPs know little about the third sector and if they commission they may not commission from us. We will look at this- a meeting later on with officials and we discussed how we can work with GPs to provide information and support for consortia. I suspect the new NHS Commissioning Board can also play a role in setting frameworks? We are plannig a top level dinner between leading consortia GPs and top health charity CEOs ( just one of many events we are planning!)

Then it was off to the Cabinet Office to celebrate Pat Samuel's retirement from the civil service. I've know Pat for years- from her time in the third sector unit in HMT and then in OTS- OCS. She is an outstanding example of a fine modern civil servant. She has been a true friend of the sector. The secotr establishment turned out in force to celebrate.

Here are the acting CEO of ACEVO, Seb Elsworth and little old me with Pat!




We have suggested to Pat she will be wasted in retirement- and we have some superb internships at ACEVO we can offer.....

Wednesday, 13 April 2011

Choice and Competition

I have been asked by the PM to chair a review of choice and competition provisions in the Health Bill as part of the current listening exercise. There are 4 of us who will lead panels reviewing aspects of the Bill, led by Steve Field , the former President of the Royal college of GPs.

The aim is to conduct a major engagement process and produce a report by end May for the PM and Andrew Lansley. It is an independent review- a point that I intend to take very seriously!

Perhaps a daunting task; as I said when I thanked David Cameron for handing me the political hot potato when the Panel met with him, Clegg and Lansley!

The ACEVO board have agreed I do this full time for the next 2 months , for which I'm grateful as this is not exactly an easy task. And I have to admit that after I had the call and said yes I then spent a sleepless night wondering quite what I'd agreed too!

But the reality is that reforms to open up choice for patients and citizens is crucial to a thriving an successful NHS. When 70% of the budget is spent on long term conditions and we all grow older for longer then the current NHS model will fail. We have to look at how we can extend choice so people can choose the right treatments and care plans that suit them. We need the many excellent health charities who work with people with long term conditions empowered to provide support , advice and research.

There is limited choice in our NHS at present. Extending choice will strengthen and protect the NHS for the future. Competition is merely a means to an end; it helps secure a greater diversity of providers to enable that choice to be made.

I think that government has , so far, failed to communicate this effectively. So part of my role is engagement with professionals, patient groups, community organisations ,unions and the third sector to see how we can ensure that citizens can get the best from the reforms and make the NHS even better.

I'm now on my way to No 10 where the PM is holding a round table for third sector organisations on health reforms. It's great that the very first event in the listening programme is with our sector.

So, blog readers, tell me your solutions for reform!

Monday, 11 April 2011

Brixton 30 years on

" Celebrations" if that is the word to mark yesterday the 30th anniversary of the Brixton riots; an event I remember well. The chaos and the damage in the heart of the town was appalling. There is nothing pleasant about a riot I thought as I joined others in surveying the damage. I'd been living in Brixton for 3 years by then.

It was those events that largely spurred me to stand for the Council in the 1982 elections and found myself, somewhat surprisingly , elected to represent the good citizens of Clapham.

Brixton is now a very vibrant and successful place to live, why it even attracts the likes of the leaders of the third sector there! Seb Elsworth, Nick Wilkie and Matthew Thompson for example!

One of the strong lessons of subsequent events and the massively influential Scarman report , was how crucial the role of the third sector to community cohesion.

The council and its services were dominated and led by white people and the services often alienated the strong local black community. The black community back in 1981 had developed their own black led organisations and support structures. It was only by working with those community led bodies and with national charites that Brixton could be revitalised.

The role of the third sector in redevelopment and revitalising civic life has been uncommented and unresearched. It should be better known.

I'm now off to see Sir Bob Kerslake , the new Permanent Secretary at DCLG; to talk about how our sector can play a much bigger role in delivering services and developing communities.

Friday, 8 April 2011

Are we up for it?

An interesting lunch with members in Manchester talking about the CEO leadership role. One of our conclusions was on the importance of looking forward and grabbing opportunities.

And then this morning I speak at a breakfast session for the Directors roundtable, a major international leadership development body , which pro bono helps leadership learning. I was speaking with Connie Collingsworth, who is the General Counsel for the Bill and Melinda Foundation.

Both events made we wonder about whether our sector has the strength and capacity to rise to current challenges.

There is no doubt that longer term , when we have struggled through the cuts and austerity our sector will grow. How far it grows is partly a matter for us.

Are we fit for purpose for growth?

# Scale

Some seem to have a problem with this ?
There is no doubt that scale matters in service delivery. The work programme shows that. The lack of Third sector primes is hugely disappointing. But that ought to move us from whinges to action- and that means developing alliances of small and large organisations and consortia to bid.

# Big v Small

Arguments about small is beautiful , big is bad are juvenile and damaging. There are sector bodies like Locality that know the strength of partnership. Is it time that all organisations in our sector looked at this message; is there is a particular role for leadership from national bodies here ?

We have a task ahead of us and need to recognise that our capacity at local level is week. Capacity at national level must also be strengthened but more alliances , rationalisation and merger might strengthen both ? One of the comments I get from local councils and health bodies is that they would like to do more through the sector but face a weak and disparate infrastructure locally, and uncertainties about how to engage with national organisations . Of course this is partly an excuse for their inaction, but is there a hint to us there to get better?

If we are to build a sector capable of massive growth we need to develop those consortia of local and national delivery organisations. That will require existing local infrastrucutre bodies to work with nationals and larger charities. It will mean national organisations looking to local opportunities and partnerships ; and yes closer working of national infrastructure bodies!

We will also have to grow the loan finance systems through social finance and banking reform.

This also will require strong leadership nationally. I do sometimes despair when I read articles like a recent one in Third Sector denouncing loans. Telling organisations not to take loans is unhelpful ,especially when this may be the way to secure a more diverse income stream . Access to capital is the biggest barrier we face to growth.

I suspect that just as the sector will grow dramatically in the long term, so will the infrastructure of our sector at local and national level . Recognising some of its weaknesses is crucial to doing something about it?

Thursday, 7 April 2011

Health and happiness!

I was not happy. Stuck on the platform at Waterloo station for a non moving train to take me to Frimley Hospital! I was supposed t be at the launch of the new "listening" exercise on health service reform. In the end I got there for the last question to the panel of PM, DPM and Andrew Lansley, courtesy of a cab!




Then a mad dash back to a meeting at OCS of the strategic partners, arriving there late too. And to complete the pattern of the day got to the launch of "Locality " at the House of Lords late too. But not too late for drinks so all not totaly lost. Good to see Steve Wyler in his element as the new CEO of the merged body. Steve is a good ACEVO member and strong leader. He understands the value of small and large bodies , in community and national organisations working together rather than playing that crude and unhelpful " small is beautiful " card. Our 2 management teams are getting together soon.

And another ACEVO member, Clare Gilhooly, CEO of Cambrdige House was there cooing about her great triumph in refurbishing her premises, which is a magnificent " settlement" in South London which now provides a thriving and energetic community hub. Sounded so good I thought we might be having an ACEVO event there ( and she said I could bring my own wine! ).



Steve Wyler and Clare Gilhooly

Driven by the cuts, but not just by that, lots of members have been flagging up the need for support in agreeing new strategic priorities, considering mergers and acquisitions or how to go about downsizing. So an important task for ACEVO is providing support to members in that process. Crucial to success is a talented and dynamic top team. It goes without saying you need a brilliant CEO and a good Chair is pretty helpful too! So I'm a fan of search. It got me to ACEVO. It got me my top class Deputy !

I’m really pleased that we have been able to agree a long-term strategic recruitment partnership with attenti.

We will be working closely with them to help shape and deliver a range of cost effective advisory, consultancy and recruitment services. That great headhunter extrodinaire David Fielding now leads the practice at attenti. Sharp readers of the Blog know he has worked with me and many of our members over the past decade. He is brilliant and trusted by many. He even gets regular mentions by Sir Robin Bogg.

I’m also looking forward to working with attenti’s Chairman, James Cann (not the actor but the media and business guru). James will speak at the ACEVO annual Chief Executive conference on driving innovation.

Here is the link to the attenti website http://www.attenti.co.uk/

Now off to Manchester for an ACEVO learning with leaders lunch, part of our ACEVO north leadership series. Let's hope the wretched trains manage to work properly today!

Tuesday, 5 April 2011

Health reform

Our third sector plays a huge role in the provision of health and social care, in promoting better health outcomes, in research and promotion and advocacy.
It's one of the historic roles for our country's charities; just look at Guys and St Thomas' in London or St James in Leeds. Great hospitals that began their life as charities.

The Lansley reforms could see a growing and welcome increase in third sector involvement in health service delivery. Indeed I believe without that growth the NHS cannot continue to provide the services we need.

It's one of ACEVO's biggest membership areas and so the current health reforms are a major issue for the sector. I believe that the time for reform is now, and whilst further debate is now being encouraged we cannot ignore the need for reform.

Increasing sums are being spent on long term conditions ( already the biggest portion of the whole budget) ; yet our health service is ill equipped in handling the services needed to prevent further increases. Many people with long term conditions need support and advice in the management of their conditions but the health service is often not best equipped to do this.

Look at the example of diabetes. People with type 2 need support on exercise and diet, life style management, on best methods to manage the condition to prevent early onset of Type 1 insulin dependence. So organisations like the magnificent Diabetes UK should be resourced and empowered to lead this fight. Not doctors.

We have a service that is still often unresponsive to patients and where the voice of patients or communities is weak and often ignored. That is where many health charities began their journey; in demanding a better voice for people with disabilities, with mental health problems, with long term conditions. Andrew Lansley's " no decision about me without me" is noble aim and one we strongly support.

The concept of " any willing provider" enshrines the idea that what matters to patients is what is delivered, not who delivers the service. I believe this offers a strong avenue for our sector to increase its role in delivery, in innovation and advocacy .

Of course a reform as radical as proposed ( and indeed as complicated )raises real issues of concern and so a period of further consultation must be welcome. But reform is needed. Along with others I've been asked to a No 10 round table next week to discuss to discuss the greater involvement of social enterprises and the voluntary and community sector in the delivery of NHS services.

I welcome this. And I shall argue reform offers us huge opportunities and we must work with the DH to ensure that reform delivers that. This is not about privatisation, as often portrayed in the media .

We are in active discussion with DH about how the sector can increase its role for the future and we are also about to start a project with ippr looking at practical ways to get GP commissioners and third sector organisations working together on the design and delivery of services. By bringing GPs and third sector leaders together over the next few months we’re hoping this will result in practical new work emerging between the GP consortia and ACEVO members.

Friday, 1 April 2011

Running Policy for Government

Great news this morning! A call from the Office of Civil Society to confirm that a deal has been done. We have been in detailed discussions with them about a contract to run their entire policy development. It has been obvious for some time that the major policy development work on the third sector and Government takes place in acevo. So we have signed a contract that ensures a partnership between us and Government on policy , with the lead work on this in the Acevo office , working to broad general oversight by the OCS.

The Acevo staff are delighted at such public recognition and I have seen the draft of the press release from Nick Hurd MP showering praise on acevo's work in developing a better understanding of how to promote Big Society. A generous payment will be made for this contract,building on the increase in our strategic partnership grant. Obviously we will work with others in this new deal. I shall ne talking to Sir Stuart about how the Ncvo research feeds into this ( and we shall even pay!) .

This is also great tribute to the work of Ralph Michell who is recognised internationally for his policy brain. I have
Promoted him to Director and he is going to have to recruit more staff ,so he is off to his old Oxford college to do this next week.

What a great week.